ESPE Abstracts

Background: Increased cerebrovascular morbidity and mortality was reported in adults who were treated with growth hormone (GH) during childhood, including those born SGA, compared to the general population. However, previous studies did not have an appropriate control group of untreated SGA adults which was a major limitation.

Objective: To assess cerebrovascular abnormalities (aneurysms, previous intracerebral hemorrhages and microbleeds) using brain MRI in adults born SGA at 12 years after cessation of childhood GH-treatment (SGA-GH) compared to age-matched untreated control groups.

Methods: We prospectively compared the prevalence of cerebral vascular abnormalities in adults born SGA who were treated with GH during childhood (SGA-GH) and 3 untreated age-matched control groups around age 30 years: born SGA with persistent short stature (SGA-S), born SGA with spontaneous catch-up growth to a normal height (SGA-CU) and born appropriate for gestational age with a normal height (AGA). All brain MRIs were performed between May 2016 – December 2020 on the same 3T MRI system. MRI images were scored by two neuroradiologists who were blinded to patient groupings.

Results: 301 adults were investigated (94 SGA-GH, 42 SGA-S, 69 SGA-CU and 96 AGA adults). Aneurysms were found in 6 adults: 3 (3.6%) SGA-GH, 1 (2.9%) SGA-S and 2 (2.2%) AGA adults, without differences between SGA-GH adults and the 3 control groups. Previous intracerebral hemorrhages were found in 2 SGA-S adults (4.8%). Microbleeds were found in 17 adults: 4 (4.3%) SGA-GH, 4 (9.5%) SGA-S, 3 (4.3%) SGA-CU and 6 (6.3%) AGA adults, also without differences between SGA-GH adults and the 3 untreated control groups.

Conclusion: Long-term GH-treatment during childhood does not increase cerebrovascular abnormalities in SGA-GH adults compared to SGA-S, SGA-CU and AGA adults.